Is the hesitation to assign personal responsibility for one’s own health a reflection of society’s acceptance of excuses? Optimal health generally requires behavior that supports it. Genetics and bad luck aside; physical, behavioral, and social challenges often become the reason for status quo rather than the spark for changes that can improve ourselves.

Working with employers it is very interesting that as wellness teams and health strategies move down their pathways, they invariably get to the point where the easy stuff is done. Health assessments, biometrics and activities make everyone feel better because they are easy to do and measure. But are people changing? Often the answer is–not enough of us. And that means a lot of work for little meaningful health improvement.  Are we to blame?

The next step, and it is a difficult one, is outcomes-based programs. That means that besides doing “stuff”, you actually need to either maintain near-optimal health status (if you are actually healthy) or improve in some way (within accepted ACA rules around incentive programs). People hate being told to change when they are not ready. But how long should we wait? How sick do we all have to get before the finances force us to improve or go broke caring for preventable disease?  If you have health insurance through an employer, what do you think about them charging you more if you don’t do all you can to stay or become healthier?

As a society, we should expect that each individual do whatever he or she can to preserve their own health. Good health reduces our dependence on the system, maintains our ability to stay productive and happy, and insures that we remain vital as we move through life. As with our education, government, and legal systems, we should not shy from demanding excellence and meaningful outcomes within healthcare. But we all impact health outcomes. If we do not hold each other accountable, we will be faced with increased disease burden and cost. And the sad reality is that failure to change both ourselves and each other in terms of health status will result in this generation living poorly and dying sooner than they should.  Should we consider health maintenance and improvement our patriotic duty?

There are many challenges and opportunities regarding health in America and this is a complex and difficult issue. But like so many problems that we face in the world, we must look in the mirror first for change that is needed within ourselves. We must participate in creating and nurturing health ecosystems that provide encouragement and support for health improvement.

Are health ecosystems complex organizations run by fancy accountable care organizations (ACOs)? They don’t have to be. An ecosystem could be some of your friends holding each other responsible for what you order at the restaurant. It could be a team of work colleagues that really understand the health plan and how to obtain resources or a group that shares a common health concern that can meet at work to discuss their challenges and successes. Whatever fosters individuals caring for each other’s health is the goal.

We must remember that traditional caregivers do not “own” our health. We do!  What do you think?